| NPI | 1720285349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 266135) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NJ 25 MA 09394700) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2024-01-16 |