| NPI | 1063435428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 038120) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 38120) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2026-07-01 |