| NPI | 1831416304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 51780) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.098847) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 300978) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0116018998) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 64437) | |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2022-03-25 |