| NPI | 1760048987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR DO215077) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV SL1476) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV DO3624) | |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2024-05-22 |