| NPI | 1700228681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A133668) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 20069) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301116435) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 2594292) | |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2023-12-11 |