| NPI | 1013129972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 53122) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 13837) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036-116801) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL MD.28865) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2018-09-19 |