| NPI | 1497788129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 69496) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 200101496) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 58090) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2021-09-14 |