| NPI | 1033178231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: AZ 13817) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: WA MD61527657) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2024-09-04 |