| NPI | 1407874761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 35357) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A64840) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2013-02-12 |