| NPI | 1841383924 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301087025)  | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 00027592)  | 
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5315052552)  | |
| Enumeration Date | 2006-10-02 | 
| Last Update Date | 2025-08-06 |