| NPI | 1265434443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 25150) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 0429835) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2002025632) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 38333) | |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2016-12-20 |