| NPI | 1003809781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 13085) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101035683) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2015-02-19 |