| NPI | 1043211212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD476807) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2009-00845) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0060993) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2022-08-28 |