| NPI | 1861984460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD209725) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC LL52507) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 342342) | |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2025-11-13 |