| NPI | 1598179285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME162512) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2017034850) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 70932) | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2024-01-22 |