| NPI | 1497775522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NV DO1473) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL TPOS607) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2023-06-23 |