| NPI | 1184626095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 30177) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 30177) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2023-11-09 |