| NPI | 1538120233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101248547) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 27742) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 050847) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2022-07-21 |