| NPI | 1417937814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 34687) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 26879) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME87443) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 31268) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: ND 12466) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2020-08-20 |