| NPI | 1881675916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ 30513) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 30513) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2025-03-20 |