| NPI | 1457613135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 129558) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 251635) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2014-04-29 |