| NPI | 1700433398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 323587-01) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL MD.43218) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U7431) | |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2026-05-20 |