| NPI | 1407946981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: VA 0101246451) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: AR E-0612) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2022-08-18 |