| NPI | 1760094593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2025013762) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-50923) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 47169) | |
| Enumeration Date | 2020-08-22 |
| Last Update Date | 2025-04-25 |