| NPI | 1316106891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 60 265935) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME153342) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2025037182) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2025040559) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2025-10-02 |