| NPI | 1972557122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0044850) |
| Additional Taxonomies | 2084N0600X (Licence: MD D0044850) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-02-16 |