| NPI | 1952569493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 269983) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D74752) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 269983) | |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 269983) | |
| Enumeration Date | 2008-05-31 |
| Last Update Date | 2023-07-07 |