| NPI | 1053336628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 21978) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 21978) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2013-06-05 |