| NPI | 1114231545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D82700) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD454433) |
| 2084N0600X (Licence: MD D82700) | |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2023-09-26 |