| NPI | 1013174143 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA MD.206169) | 
| Additional Taxonomies | 2084N0600X (Licence: LA 206169) | 
| Enumeration Date | 2008-05-16 | 
| Last Update Date | 2024-11-13 |