| NPI | 1649657651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 036-159975) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: IA R-10188) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A156692) | |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2022-08-16 |