| NPI | 1104088939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036-116615) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60140541) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 85828) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 68747) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX N2690) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2023-12-10 |