| NPI | 1275100406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 104500) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX BP10076982) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2025-05-28 |