| NPI | 1053587451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A118645) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301111674) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 62835-20) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036152718) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0059263) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA09954300) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2022-03-23 |