| NPI | 1093192486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 169237) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT MED-PHYS-LIC-113005) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2025-00074) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2024-0240) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0066317) | |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2026-08-28 |