| NPI | 1093797037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 32365) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX G8654) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036-068131) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 75253) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 42455) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME66830) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G82033) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301083374) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2020-10-01 |