| NPI | 1861447906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 38984-020) |
| Additional Taxonomies | 2084D0003X (Licence: WI 38984-20) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2020-03-11 |