| NPI | 1033178140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD045890L) |
| Additional Taxonomies | 2084N0600X (Licence: PA MD045890L) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2016-01-06 |