| NPI | 1801865365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101268933) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2020001526) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 15014) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2024-01-30 |