| NPI | 1982642617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: IA MD-40090) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301064663) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: IA MD-40090) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2023-11-16 |