| NPI | 1346266863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DE CL0005148) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD061195L) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2008-07-29 |