| NPI | 1710045844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 245044) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NJ 25MA09545000) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2023-05-30 |