| NPI | 1285791079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA OP00001885) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR DO29116) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2011-03-25 |