| NPI | 1700872561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA09666600) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 226246) |
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: MA 226246) | |
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: NJ 25MA0966600) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2016-11-23 |