| NPI | 1326248824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX P4843) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 20738) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2014-09-23 |