| NPI | 1124195417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DE C1-0007775) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME94931) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2025-10-24 |