| NPI | 1205994670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 200569) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 74843) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-09-18 |