| NPI | 1649382276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101266344) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: TN 27929) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036164697) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-06-13 |