| NPI | 1083603062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD052377L) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA 052377L) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2024-03-02 |