| NPI | 1972744894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 27603) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0060992) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2025-11-04 |