| NPI | 1316100043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 31048) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL31048) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2014-07-15 |