| NPI | 1346354982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 211960) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 211960) |
| 2085N0700X Radiology, Neuroradiology (Licence: NY 211960) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2022-07-12 |