| NPI | 1548618705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MB10907200) |
| Additional Taxonomies | 2084N0600X (Licence: NJ 25mb10907200) |
| Enumeration Date | 2016-05-28 |
| Last Update Date | 2026-01-16 |