| NPI | 1447516083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: IA 44940) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CO DR.0056488) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2018-07-24 |