| NPI | 1114260619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X (Licence: CO DR.0058144) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CO 0058144) |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: CO DR.0058144) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2021-12-07 |