| NPI | 1467832600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2015014077) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ZZ 09/10/1987) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2017-11-16 |