| NPI | 1932620259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 87361) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 009258) |
| 208VP0000X (Licence: SC 87361) | |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2022-08-25 |