| NPI | 1093923146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MS 20435) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME109995) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2023-12-07 |