| 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 | 2024-03-01 |