| NPI | 1396032934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 59064) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA MD-53036) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD485254) | |
| 2084N0600X (Licence: TX Q4668) | |
| Enumeration Date | 2011-07-04 |
| Last Update Date | 2025-04-18 |