| NPI | 1730263146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 32424) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 034237) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 034237) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-10-20 |