| NPI | 1346249455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME97839) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC 33498) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2015-07-10 |