| NPI | 1407836299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101048901) |
| Additional Taxonomies | 2084D0003X (Licence: VA N10020408) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2024-10-10 |