| NPI | 1902484512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036.170760) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA12669800) |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2026-07-29 |