| NPI | 1942351267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 229791) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 52081) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2026-01-19 |