| NPI | 1376566984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD-033881-E) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD-033881-E) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2014-09-10 |