| NPI | 1649621269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: PA MD475332) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD475332) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA11256700) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NJ 25MA11256700) | |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2024-03-04 |