| NPI | 1346200524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR DO29152) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV D01594) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2017-09-26 |