| NPI | 1407419989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: NY 308498) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: NY 308498) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 308498) | |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2024-08-05 |