| NPI | 1174796981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ID M-17444) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA ML60233911) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD171653) | |
| Enumeration Date | 2008-04-12 |
| Last Update Date | 2024-02-19 |