| NPI | 1063400208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD-055122-L) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: PA MD-055122-L) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: PA MD-055122-L) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD-055122-L) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2013-06-19 |