| NPI | 1598110058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME159011) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: NY 303864) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 303864) | |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2022-11-04 |