| NPI | 1700013570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 40761) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AK 7847) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2026-05-02 |