| NPI | 1336171727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 192887) |
| Additional Taxonomies | 2084H0002X (Licence: NY 192887) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-06-29 |