| NPI | 1578680914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NJ 25MA08248800) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA08248800) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101044892) | |
| 208D00000X General Practice (Licence: VA 0101044892) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2022-04-24 |