| NPI | 1083027403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA MD-43886) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA R-09971) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2018-07-09 |