| NPI | 1750743571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0062961) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U6209) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME162552) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2025-01-09 |