| NPI | 1467409920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WA MD60553868) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: TN 49119) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 040664) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2020-12-03 |