| NPI | 1184785859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 2010-01733) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 234548) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2014-02-10 |