| NPI | 1497735096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 179416) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NY 179416) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NY 179416) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 179416) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2021-04-28 |