| NPI | 1437644515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 72540) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 010082) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2023-05-26 |