| NPI | 1023351285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OS019038) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI DO01463) |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2025-09-30 |