| NPI | 1659363190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: OR MD23516) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD476319) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 87993) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME14804) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MT 91890) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: NH 21543) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2023-01-04 |