| NPI | 1609837913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD26492) |
| Additional Taxonomies | 2084N0600X (Licence: OR MD26492) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2021-03-19 |