| NPI | 1730675117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 89512) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX BP10063903) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2024-07-24 |