| NPI | 1558488197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA08576600) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME143961) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01090776A) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX R1831) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 40290) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2026-02-09 |