| NPI | 1629097852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: NJ 25MA08706000) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME 016111) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2026-05-18 |