| NPI | 1386796191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX Q4810) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 19853) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 13157) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2022-09-08 |