| NPI | 1285661991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2009-01156) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 30913) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME 018736) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2023-10-17 |