| NPI | 1700089166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NJ 25MA09135700) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MT190276) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2023-10-25 |