| NPI | 1013235886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0102203037) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 007575) |
| 208D00000X General Practice (Licence: VA 0102203037) | |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2023-03-07 |