NPI | 1326229691 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 276346-1) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA09276600) |
2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: NY 276346-1) | |
Enumeration Date | 2007-11-15 |
Last Update Date | 2021-01-08 |