| NPI | 1265827901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD049385) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA R10269) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301117539) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2023-02-16 |