| NPI | 1801888433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME97659) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 58223) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 100944) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 57844) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 34475) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2026-08-21 |