| NPI | 1568422848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD067617L) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25IA12892800) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2026-06-25 |