| NPI | 1518196807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 62794) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 751-L) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 22714) | |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2018-01-24 |