| NPI | 1861489601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 202568) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2023010521) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 70388) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101276849) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036169424) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME168650) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2024-00360) | |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2024-11-06 |