| NPI | 1174729404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NM MD2011-0474) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NM MD2011-0474) |
| Enumeration Date | 2007-06-24 |
| Last Update Date | 2011-11-17 |