| NPI | 1912900135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MD H0039910) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL OS 12461) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2021-09-17 |