| NPI | 1598147134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VT 042.0040177) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL MD.37713) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2026-05-29 |