| NPI | 1033602040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD H95435) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5101024175) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OS024179) | |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2024-09-26 |