| NPI | 1265692073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 2018-00949) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 2538571) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2018-04-27 |