| NPI | 1518191089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 56629) |
| Additional Taxonomies | 2084H0002X (Licence: MN 56629) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2023-09-06 |