| NPI | 1295990554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MD D77954) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD445778) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2015-07-24 |