| NPI | 1932182268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 20298) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 63395) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 31257) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2020-09-09 |