| NPI | 1568705614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0063884) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A134757) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME136493) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2020-06-15 |