| NPI | 1578590105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX J4217) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX J4217) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2023-08-07 |