| NPI | 1659524387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD437055) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 242708) |
| Enumeration Date | 2008-10-26 |
| Last Update Date | 2020-12-24 |