| NPI | 1487809307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 87620) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA mt187913) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2021-03-23 |