| NPI | 1881000271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 305556) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD465633) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 6996) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2020-07-31 |