| NPI | 1952332132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY C0054) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 30428) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 9401492) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WY TL8273) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-07-09 |