| NPI | 1932131265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: DE C1-0011895) |
| Additional Taxonomies | 2084E0001X (Licence: DE C1-0011895) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD418067) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-01-31 |