| NPI | 1245278712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MO R3L28) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: KS 05-26084) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2017-11-15 |