| NPI | 1467682245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NV 16334) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: WA MD60605155) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME105596) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: CA C150064) | |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2023-10-03 |