| NPI | 1083929160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO Dr.0064850) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WY 9692A) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 61128) | |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2020-09-17 |