| NPI | 1346448875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 40235) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA R8145) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036.128595) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2013-06-06 |