| NPI | 1447406004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D73831) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD040060) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2022-01-28 |