| NPI | 1649487588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SD 7690) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA MD-38454) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA R-7674) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2018-07-31 |