| NPI | 1477541480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 2021-00163) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: IA 37178) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: IN 01057675A) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: WA 60193652) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MD D72841) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2021-09-07 |