| NPI | 1316568728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR DO207208) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 100738) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 305084) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 22266) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2021046265) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OS022030) | |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2023-08-30 |