| NPI | 1982091666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 336721) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 63913) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2025-08-28 |