| NPI | 1700895083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2009004527) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 48941) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 102605) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2024-05-02 |