| NPI | 1598886855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 70157) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC TL30217) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2025-01-14 |