| NPI | 1457335994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 29047) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME127231) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 33826) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2016026970) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VT 042.0012901) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 60040) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 15084) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 075778) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 43464) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 16343) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 65691) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME MD20204) | |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2025-10-31 |