| NPI | 1043692536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD489325) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DE C1-0013605) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2025-04-08 |