| NPI | 1245230341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E4264) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX J8964) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2020-04-02 |