| NPI | 1831483213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NV DO1937) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: NV SL0804) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2021-01-27 |