| NPI | 1104317056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD481785) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 351638) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A178055) | |
| Enumeration Date | 2018-05-27 |
| Last Update Date | 2026-07-12 |