| NPI | 1689013831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD449002) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA09768900) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2025-09-25 |