| NPI | 1942450002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 83743) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 42551) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101251178) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2022-02002) | |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2024-02-09 |