| NPI | 1871848853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MO 2012018828) |
| Additional Taxonomies | 2084H0002X Psychiatry & Neurology Hospice and Palliative Medicine (Licence: NY 301718) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2022-05-16 |