| NPI | 1841444288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 52610) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY P59139) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 14337) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY TP435) | |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2021-06-25 |