| NPI | 1558377879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX Q2381) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD429305) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 24709) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 37666) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-10-13 |