| NPI | 1427164391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD461654) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 37903) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2022-07-21 |