| NPI | 1427035278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 322296) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME137156) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 30150) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2020-08-17 |