| NPI | 1659638708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 259539-1) |
| Additional Taxonomies | 2085N0700X (Licence: NY 259539) |
| 207R00000X Internal Medicine (Licence: NY 259539) | |
| 207R00000X Internal Medicine (Licence: NJ 25MA09113800) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 259539) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NJ 25MA09113800) | |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2025-02-03 |