| NPI | 1770780850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 261068) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 233373) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2014-11-21 |