| NPI | 1972576940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 51916) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2008028207) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 36752) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2022-05-02 |