| NPI | 1538132303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: NJ 25MA10970600) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 55683) |
| 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: NJ NJDCATEMP-029052) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MN 47675) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: NJ 25MA10970600) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2024-04-17 |