| NPI | 1225105026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 2011-00665) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 13828) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2011-05-09 |