| NPI | 1003820325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 23957) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 71916) |
| 2084N0600X (Licence: MA 71916) | |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2023-07-18 |