| NPI | 1104844695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD040049) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2007006293) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2014-06-24 |