| 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) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2024-10-07 |