| NPI | 1114192853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 260701) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 260701) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2023-10-23 |