| NPI | 1619043973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0040133) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD32221) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101225623) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2021-06-01 |