| NPI | 1942418090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2021-02886) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101247011) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD444704) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 86219) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 310499) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2025-10-06 |