| NPI | 1609030824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD446412) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 036127336) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2021-07-30 |