| NPI | 1093021198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X (Licence: MA 245552) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 245552) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2010-08-26 |