| NPI | 1003800665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 52072) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: GA 052072) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2018-01-31 |