| NPI | 1649281833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD018656E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA 018656E) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2021-03-29 |