| NPI | 1568649085 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0053116) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 67059) | 
| Enumeration Date | 2008-01-28 | 
| Last Update Date | 2016-08-26 |