| NPI | 1811904352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101052078) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 010152078) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2024-01-22 |