| NPI | 1467458422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX H1627) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX H1627) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2008-07-15 |