| NPI | 1437141306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 091802-1) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 091802-1) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2025-09-11 |