| NPI | 1598736654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 209690) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: NY 209690) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 209690) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2021-05-05 |