| NPI | 1043259641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0059720) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WY 3823A) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-07-04 |