| NPI | 1558543595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084E0001X (Licence: IA MD-42117) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CT 046592) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: IA MD-42117) | |
| Enumeration Date | 2007-12-01 |
| Last Update Date | 2023-11-16 |