| NPI | 1245493402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2012009717) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125-055311) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME161484) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U3562) | |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2024-04-05 |