| NPI | 1396748075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX F6701) |
| Additional Taxonomies | 2084D0003X Psychiatry & Neurology, Diagnostic Neuroimaging (Licence: TX F6701) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2009-06-27 |