| NPI | 1962568964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD17271) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D28360) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101043038) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2021-06-21 |