| NPI | 1447455472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD440204) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY P76343) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2011-03-13 |