| NPI | 1164586152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 0425486) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2926) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 84141) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2007-07-08 |