| NPI | 1891742144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301079153) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI PA079153) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2024-02-23 |