| NPI | 1992749329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-10819) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX J7038) |
| 208100000X Physical Medicine & Rehabilitation (Licence: TX J7038) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-04-15 |