| NPI | 1215384466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 304510) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ r75539) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 70042) | |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2023-11-21 |