| NPI | 1063587384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2021008271) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00024167) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01075561A) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 59863-20) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2021-12-01 |