| NPI | 1821520412 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: PA MD476935)  | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD476935)  | 
| Enumeration Date | 2017-04-01 | 
| Last Update Date | 2023-01-23 |