| NPI | 1982807921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME159967) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U7677) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2023036416) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 126352) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD444375) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2024-04-05 |