| NPI | 1891134037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO CDRH.0063900) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2015025825) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-46008) | |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2023-11-27 |