| NPI | 1669715009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 05-53385) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A13871) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2026-09-10 |