| NPI | 1558628826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: CO DR.0057105) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0057105) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2018-06-11 |