| NPI | 1295350551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 13928862-1205) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4351046241) |
| 2084N0600X (Licence: UT 13928862-1205) | |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2025-03-09 |