| NPI | 1013906759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2023022349) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SD 7631) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 224676) | |
| Enumeration Date | 2005-10-16 |
| Last Update Date | 2023-09-12 |