| NPI | 1346444742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME130134) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD30044) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2016-11-01 |