| NPI | 1457465528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PR 12570) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME 73103) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0059010) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 37868) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX P4796) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-10-07 |