| NPI | 1851359244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 15200R) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ND 11562) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-02-21 |