| NPI | 1881859460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 47108) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 47108) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 47108) | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2024-03-29 |