| NPI | 1417445677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 11093) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME158739) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX BP10077870) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T9043) | |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2024-04-05 |