| NPI | 1336295674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2008010181) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY R1013) |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2025-05-28 |