| NPI | 1033347349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR DO168057) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC LL1267) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC LL1267) | |
| 2084N0600X (Licence: OR DO168057) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2015-03-20 |