| NPI | 1811280100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 0439029) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME158957) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S2591) | |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2024-04-05 |