| NPI | 1508816653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0030890) |
| Additional Taxonomies | 2084N0600X (Licence: CO 30890) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2018-11-17 |