| NPI | 1740365063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2010-01547) |
| Additional Taxonomies | 208VP0000X (Licence: NC 2010-01547) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2021-04-07 |