| NPI | 1659721884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD477791) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2020007995) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA FU144066) | |
| Enumeration Date | 2016-06-19 |
| Last Update Date | 2024-12-11 |