| NPI | 1003019209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2026-03622) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125052064) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2026-08-25 |