| NPI | 1821071192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 270535) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 030692) |
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: NY 270535) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2013-12-02 |