| NPI | 1710998000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 43453) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 26868) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2024-05-10 |