| NPI | 1144756180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 32476) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 227461) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101272509) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-06-28 |