| NPI | 1710253737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 284452) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA MD-53916) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036-151105) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A148960) | |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2025-04-23 |