| NPI | 1417156886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 34203) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CT 045635) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2019-07-11 |