NPI | 1588983761 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 278427) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA10461800) |
Enumeration Date | 2010-05-26 |
Last Update Date | 2025-06-12 |