| NPI | 1891768404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NJ 25MA10525400) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA10525400) |
| 174400000X Specialist (Licence: PA MD072193L) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2021-04-29 |