| NPI | 1467532093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME67265) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME67265) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2016-01-27 |