| NPI | 1942632880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 310590) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME MD21438) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2023-08-10 |