| NPI | 1962701219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 18133) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0055890) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125060435) | |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2022-10-27 |