| NPI | 1962964387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A182457) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD492374) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: DE C1-0028754) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0104863) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2025-02987) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 95866) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 82253) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME177258) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 109942) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA12905700) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101286633) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 51799) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD600004555) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 339398) | |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2025-11-20 |