| NPI | 1942596523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2016025183) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX BP10040654) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2020-07-16 |