| NPI | 1316904238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: MO R7G56) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO R7656) |
| 174400000X Specialist (Licence: KS 0427275) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2007-09-27 |