| NPI | 1528037991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: MO 2005020352) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2005020352) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2005020352) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2023-08-10 |