| NPI | 1629426630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0068239) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A154050) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2025-01-09 |