| NPI | 1538645841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 330109) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 29109) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MT226860) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD479289) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 29809) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 66485) | |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2024-09-16 |