| NPI | 1093938458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA MD203266) |
| Additional Taxonomies | 2084D0003X Psychiatry & Neurology, Diagnostic Neuroimaging (Licence: AL R9324) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2019-01-02 |