| NPI | 1346231677 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D064936)  | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX K7736)  | 
| Enumeration Date | 2005-11-04 | 
| Last Update Date | 2007-11-21 |