| NPI | 1912141870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 51081) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: AZ 51081) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2020-01-29 |