| NPI | 1932211232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 47701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP6422) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-08-08 |