| NPI | 1245436955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 52158) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301092121) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2016-01-29 |