| NPI | 1770560120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NJ 25MA09763100) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 204399) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2024-07-02 |