| NPI | 1659486611 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ MD441206) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 250553) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 061992) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME103679) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 154) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 227814) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 26337) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101244690) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA04595600) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2023-01-20 |