| 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 |