| NPI | 1922058023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25IA12904000) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 31032) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2025-12-04 |