| NPI | 1821658915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 82947) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC LL82877) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX V1419) | |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2026-06-09 |