| NPI | 1912108333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 52282) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 51136) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 104334) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-18 |