| NPI | 1649500158 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2011-00255)  | 
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: NY N/A)  | 
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 201100255)  | |
| Enumeration Date | 2010-01-05 | 
| Last Update Date | 2025-05-20 |