| NPI | 1881731214 |
|---|---|
| Former Name | MARCO AURELIO BUENO PALACIO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME72493) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 041408) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2007-07-08 |