| NPI | 1598094393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 85697) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2014021713) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2021-07-27 |