| NPI | 1407064785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 40439) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036126114) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2012-08-16 |