| NPI | 1053487314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0020799) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 246853) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD15170) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101035443) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2009-10-05 |