| NPI | 1447660220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA OS019317) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 300333) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2023-06-30 |