| NPI | 1033163266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2008003316) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 23662) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 36617) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2016-03-21 |