| NPI | 1427367499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA OS017746) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA ot013641) |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2015-08-12 |