| NPI | 1902167323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA RTP006157) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 284579) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 82461) | |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2021-02-02 |