| NPI | 1386780914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD479606) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD d69879) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD P19641) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2022-11-09 |