| NPI | 1477692416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60295880) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2011-0617) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2015-04-16 |