| NPI | 1831102250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 036.124195) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NJ 25MB07991500) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2019-06-24 |