| NPI | 1235391046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: MS 21995) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 21995) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2025-10-02 |