| NPI | 1891767042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 40222) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 71651) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2018-0645) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2025-09-10 |