| NPI | 1649320987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL OS10770) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA OS019617) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: NH 17444) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 2010-01765) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2023-01-04 |