| NPI | 1902488687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0102210132) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0116035045) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2026-08-12 |