| NPI | 1912167594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME113653) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.127048) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: ND 13928) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD171344) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 28576) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 24415) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 17261) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 281547) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301114103) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX TM00615) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2023-01-04 |