| NPI | 1861986481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X (Licence: MI 4301506532) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301114695) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2025-05-28 |