| NPI | 1144484619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 294796) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036.125933) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2022-11-14 |