| NPI | 1144581661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101262243) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 50268) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2025-02-05 |