| NPI | 1356367684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 41153) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 041153) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2021-06-08 |