| NPI | 1861074742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-51473) |
| Additional Taxonomies | 2084N0600X (Licence: KS 04-51473) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2025047602) | |
| 2084N0600X (Licence: MO 2025047602) | |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2026-07-23 |