| NPI | 1871545921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME81264) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-14660) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 38665) | |
| 2084N0600X (Licence: AR E-14660) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2024-04-19 |