| NPI | 1063788875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 46224) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 46224) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 46224) | |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2024-03-04 |