| NPI | 1033202551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 18766) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: NC 18766) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2015-04-08 |