| NPI | 1376757344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: CO DR.0051735) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2007011386) |
| 2084N0600X (Licence: NM TM2013-0690) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2025-10-20 |