| NPI | 1831695329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 95466) |
| Additional Taxonomies | 2084N0600X (Licence: GA 95466) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2025-10-06 |