| NPI | 1922621754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 3127) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA DO-06941) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2026-06-03 |