| NPI | 1164862413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2017-0956) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 103657) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2024-02340) | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2025-10-08 |