| NPI | 1295715456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 110311) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: NY 110311) |
| 207R00000X Internal Medicine (Licence: MD 110311) | |
| Enumeration Date | 2006-01-21 |
| Last Update Date | 2012-07-27 |