| NPI | 1275950487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: NY 281490) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 281490) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2025-05-13 |