| NPI | 1396849493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD 051729L) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: PA MD 051729L) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2007-07-10 |