| NPI | 1720387764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NJ 25MA11275100) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NY NCC5503) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 278762) | |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2026-04-15 |