| NPI | 1821203894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2010-00487) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5101016796) |
| Enumeration Date | 2007-05-13 |
| Last Update Date | 2021-11-29 |