| NPI | 1689359408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC MMD.90174LL) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC MMD.90174LL) |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2023-06-19 |