| NPI | 1548581275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101267645) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-16177) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 275302) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2022-0223) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2023-01489) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 69956-20) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 258530) | |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2026-07-27 |