| NPI | 1235335993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: VA 0101244345) |
| Additional Taxonomies | 2084P0301X Psychiatry & Neurology Brain Injury Medicine (Licence: VA 0101244345) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2022-06-08 |