| NPI | 1639226426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 30227) |
| Additional Taxonomies | 2084N0600X (Licence: SC 30227) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2021-04-23 |