| NPI | 1326243544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301099265) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 0450009) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 40163) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2024-11-12 |