| NPI | 1619312246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X (Licence: MI 4301507700) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301507700) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2024-05-23 |