| NPI | 1437318573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 248606) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX N1632) |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2021-11-19 |