| NPI | 1427044643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: ID M7728) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: WA MD00037909) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: AZ 24256) | |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2024-08-07 |