| NPI | 1639389810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO CDRH.0057893) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2003024214) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-39589) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2024-02-13 |