| NPI | 1851770861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 1.062844-RES) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301107709) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MT210416) | |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2020-09-07 |