| NPI | 1821418666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U3071) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SD 11369) |
| Enumeration Date | 2014-04-20 |
| Last Update Date | 2023-10-10 |