| NPI | 1174581250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VT 042.0018921) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D56151) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2025-09-09 |