| NPI | 1003919911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 29660) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 023254) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2011-09-12 |