| NPI | 1578649224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD150664) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME165494) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00043726) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2023-12-21 |