| NPI | 1336501675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV DO2927) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ID O-1769) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2023-03-07 |