| NPI | 1295963791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2023039486) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 0451746) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 89685) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2025-09-18 |