| NPI | 1689136129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 74179-20) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 78984) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2025-02-11 |