| NPI | 1194833384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA WA OP00001680) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR OR DO15953) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2016-08-23 |