| NPI | 1770578973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD472434) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ID M-12257) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101233012) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60251550) | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2023-08-15 |