| NPI | 1457334799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 29108) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 43295) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 13725843-1205) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2025-03-07 |