| NPI | 1053379487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 2024-02443) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: VA 0101046923) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: DC MD044123) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2024-09-11 |