| NPI | 1013951029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301067690) |
| Additional Taxonomies | 174400000X Specialist (Licence: 4301067690) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-01-21 |