| NPI | 1669455663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: AZ 46437) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MO 2006009467) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2020-09-09 |