| NPI | 1972024974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 92768) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 009670) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2023-10-09 |