| NPI | 1023495413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0063537) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 696) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2022-07-28 |