| NPI | 1386025658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 93898) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: SC LL38215) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2023-02-08 |