| NPI | 1275053464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: NY 324352) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 272142) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2024-01-04 |