| NPI | 1063558476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A94763) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: HI 15313) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2015-06-12 |