| NPI | 1144648429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301502506) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MN 63981) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2020-07-17 |