| NPI | 1972845766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 52304) |
| Additional Taxonomies | 2084N0600X (Licence: SC MD52304) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2025-11-10 |