| NPI | 1578856159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0062521) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL OS19628) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2016-01799) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 338240) | |
| 208D00000X General Practice (Licence: WA 1014) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2023047856) | |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2024-01-02 |