| NPI | 1811962624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 160815) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 160815) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2024-02-19 |