| NPI | 1326627472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 337459) |
| Additional Taxonomies | 2084N0600X (Licence: NY 337459) |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2026-07-20 |