| NPI | 1134116270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 49677) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 6606) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2007-07-09 |