| NPI | 1962643015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CO DR.0052784) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A114974) |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2015-07-07 |