| NPI | 1508036195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA MD.202204) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101268488) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 202204) | |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2020-01-17 |