| NPI | 1376536029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 109602) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036.088053) |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2021-03-29 |