| NPI | 1962798892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 303144) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-248185) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 257589) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2022-11-17 |