| NPI | 1184617599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 026752) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: AL 00013067) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2007-07-08 |