| NPI | 1093740771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101249290) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: VA SUB) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 217234) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2021-04-23 |