| NPI | 1265819478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2019012538) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036152111) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 334610) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 75219) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME159856) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101279022) | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2024-05-22 |