| NPI | 1285632638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: LA 021911) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 23118) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2021-10-25 |