| NPI | 1326228222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101249385) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 38835) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2018-06-08 |