| NPI | 1568696243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR DO162367) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OT012388) |
| 2084N0600X (Licence: CO DR.0056957) | |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2025-05-19 |