| NPI | 1316203128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD458876) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D83068) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2022-07-21 |