| NPI | 1285991208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 10270104-1205) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 107086) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 56959) | |
| Enumeration Date | 2012-04-15 |
| Last Update Date | 2022-07-21 |