| NPI | 1851770408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: VA 0101266299) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: VA 0101266299) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2019-06-09 |