| NPI | 1770575656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 51347) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD471748) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301069547) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00034215) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 80919) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 20191) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2024-02-19 |