| NPI | 1760764476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OS016475) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 3785) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 8790) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 103855) | |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2025-09-20 |