| NPI | 1366428443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 9500678) |
| Additional Taxonomies | 2084N0600X (Licence: NC 9500678) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2010-11-12 |