| NPI | 1083146872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 90069) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 036.156316) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2023-06-19 |