| NPI | 1689038747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: VA 0101272260) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101272260) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2022-12-16 |