| NPI | 1407849888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 32555) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 73161) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 032555) | |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2025-09-24 |