| NPI | 1356722284 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0102204522) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL OS18829) | 
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 125638) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 34.015696) | |
| Enumeration Date | 2015-06-16 | 
| Last Update Date | 2024-11-25 |