| NPI | 1396030052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR DO173570) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA DO-05080) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2023-02-27 |