| NPI | 1043251648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI EMC0001512) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 49254) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 104055) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME156991) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SD 13136) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2022-07-01 |