| NPI | 1801861976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 139436) |
| Additional Taxonomies | 208VP0000X (Licence: NY 139436) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2016-06-09 |