| NPI | 1396970760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A139251) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT195347) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 105054) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 53412) | |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2015-11-19 |