| NPI | 1780796292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA08092900) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 1.076422) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-09-15 |