| NPI | 1255490900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME42681) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: TN 50807) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: WA MD.MD.60367324) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: SD 8313) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: TX P4598) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: CA G84179) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2021-05-25 |