| NPI | 1780713255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 198252) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA08433600) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2017-04-24 |