| NPI | 1255783270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 38794) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 1.065004) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 008863) | |
| Enumeration Date | 2016-07-02 |
| Last Update Date | 2022-06-27 |