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 |