| NPI | 1730391509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084D0003X (Licence: NJ 25MA11934400) |
| Additional Taxonomies | 2084D0003X (Licence: PA MD431575) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101247111) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036147170) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2024-09-17 |