| NPI | 1801003199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA08902600) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 221319) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD434046) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2011-12-29 |