| NPI | 1598024515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR DO176520) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV DO2823) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 13317) | |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2024-03-11 |