| NPI | 1801415575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301517585) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0100810) |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2026-06-23 |