| NPI | 1295230472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 321386) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL MD.39046) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2025-08-21 |