| NPI | 1992762918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 3445947-1205) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WY 7015A) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2022-10-27 |