| NPI | 1124087937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CO DR.0059261) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: AZ 23522) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2017-10-18 |