| NPI | 1477791879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D74128) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD 23455) |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2013-02-01 |