| NPI | 1588950232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 65786) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0054908) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2021-11-18 |