| NPI | 1780615625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD156921) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: WA MD00047890) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00047890) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2021-03-19 |