| NPI | 1720547516 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: NY 330438-01) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 330438-01) | 
| Enumeration Date | 2019-03-19 | 
| Last Update Date | 2025-03-20 |