| NPI | 1932239142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2015013515) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 51690-020) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME137753) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301116526) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX TM00794) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 19262) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-11-06 |