| NPI | 1245246990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60067848) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM 92-24) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2025-11-24 |