| NPI | 1316132319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 37849) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 17415) |
| 2084N0600X (Licence: AZ 37849) | |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2018-05-21 |