| NPI | 1972560894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2004-00969) |
| Additional Taxonomies | 2084D0003X (Licence: NC 2004-00969) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2023-06-08 |