| NPI | 1699018044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 79508) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2019-00380) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 331848) | |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2025-01-24 |