| NPI | 1770997108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC LL37138) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2019-02689) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-15818) | |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2023-05-05 |