| NPI | 1710202650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301097087) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 53723) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 93524) | |
| Enumeration Date | 2010-04-04 |
| Last Update Date | 2024-10-30 |