| NPI | 1841505963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 280893-1) |
| Additional Taxonomies | 2084D0003X Psychiatry & Neurology, Diagnostic Neuroimaging (Licence: NY 280893-1) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2017-02-21 |