| NPI | 1447346127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD444758) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 222749) |
| 204R00000X Electrodiagnostic Medicine (Licence: PA MD444758) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2017-01-19 |