| NPI | 1215067533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: AZ 13481) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NM 79173) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2008-05-06 |