| NPI | 1912918319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 32789) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: AL 32789) |
| 2084N0600X (Licence: AL 32789) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2024-02-01 |