| NPI | 1467468389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: VT 042-0008725) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 1189091) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2013-11-19 |