| NPI | 1053379487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD044123) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101046923) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2016-06-07 |