| NPI | 1134344153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 60676) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-6122) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2021-12-08 |