| NPI | 1477873016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: KY 47481) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: KY IP 1249) |
| Enumeration Date | 2010-06-06 |
| Last Update Date | 2022-02-22 |