| NPI | 1508214131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 314941) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267075) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2022-08-09 |