| NPI | 1710183041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME100599) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 28703) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 057372) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX TM00626) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.125483) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301108303) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 51221) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 24286) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 17306) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: ND 13996) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD171346) | |
| Enumeration Date | 2007-06-24 |
| Last Update Date | 2023-01-04 |