| NPI | 1356538417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 234167) |
| Additional Taxonomies | 2084N0600X (Licence: MA 234167) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2024-08-29 |