| NPI | 1316937683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00049375) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01050806A) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2019-12-13 |