| NPI | 1578618815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 200200485) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 61937) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2025-03-21 |