| NPI | 1306104633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A127359) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 70179) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301119189) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 69833) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01087101A) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2022-00120) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 53493) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036147583) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA10454400) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101266051) | |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2022-04-07 |