| NPI | 1124063375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: IA 37648) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 036116005) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2016-10-11 |