| NPI | 1982867644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: VA 0102202439) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0102202439) |
| 208D00000X General Practice (Licence: VA 0102202439) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2025-08-04 |