| NPI | 1730133158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD062295L) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA06559700) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2007-07-09 |