| NPI | 1962701219 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 18133) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125060435) | 
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0055890) | |
| Enumeration Date | 2011-03-24 | 
| Last Update Date | 2025-08-20 |