| NPI | 1861854978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD471466) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA FD3886011) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME MD24490) | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2024-04-05 |