| NPI | 1417278458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 301146) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC LL32639) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2024-08-23 |