| NPI | 1376658641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 041890) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 041890) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2018-10-23 |