| NPI | 1841248234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CO DR0071392) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 220993) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2025-04-28 |