| NPI | 1528622990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 5101026912) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 5151013417) |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2023-11-24 |