| NPI | 1659402030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 134960) |
| Additional Taxonomies | 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: NY 134960) |
| 208M00000X Hospitalist (Licence: NY 134960) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2018-12-13 |