| NPI | 1003023201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2014-02401) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D68661) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 27789) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2026-04-23 |