| NPI | 1932635539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101274323) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.146958) |
| 2084N0600X (Licence: CA A159636) | |
| 2084N0600X (Licence: IL 036162659) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-46541) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 76568) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036162659) | |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2025-05-30 |