| NPI | 1033197629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35123625) |
| Additional Taxonomies | 2084N0600X (Licence: IL 036049109) |
| 2084N0600X (Licence: IA 19525) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME88557) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 19525) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036049109) | |
| 2084N0600X (Licence: OH 35123625) | |
| 2084N0600X (Licence: FL ME88557) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2020-01-10 |