| NPI | 1629381041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S0705) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DE C1-0011177) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2025-12-05 |