| NPI | 1548756588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 310837) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036169458) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD220867) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61349471) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME162860) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2023-00847) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101279289) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 98412) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 69079) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2023047334) | |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2025-10-08 |