| NPI | 1063591857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SD 8308) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME 014738) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2013-09-30 |