| NPI | 1689785495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY TP433) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301093864) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A96585) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60705551) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-10-10 |