| NPI | 1033321914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: CO 48115) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 64995) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 6312366-1205) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 26744) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2025-10-23 |