| NPI | 1417270646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD455534) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DE C1-0012524) |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2021-08-14 |