| NPI | 1366837429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD200077) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101267054) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 20583) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD471944) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX 61643) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2020033611) | |
| Enumeration Date | 2015-04-05 |
| Last Update Date | 2024-04-04 |