| NPI | 1982044582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD462013) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL TPME106) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 079050) | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2022-09-14 |