| NPI | 1396726717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CO DR.0055372) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: AZ 46238) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: NM MD2015-0583) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 174815) | |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2024-02-21 |