| NPI | 1033506175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL OS22478) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A17256) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2025036730) | |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2025-10-02 |