| NPI | 1184285546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-44572) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL TRN29856) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2021-08-16 |