| NPI | 1417068420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT MED-PHYS-LIC-79097) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ND 5499) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-04-09 |