| NPI | 1033607791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5101025606) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5151009508) |
| Enumeration Date | 2018-04-28 |
| Last Update Date | 2022-07-18 |