| NPI | 1427140391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC 19276) |
| Additional Taxonomies | 2084N0600X (Licence: DC 19276) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2013-12-23 |