| NPI | 1417192808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX P7216) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC Training) |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2014-06-13 |