| NPI | 1740591627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 59014) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 8704008-1252) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2020-08-20 |