| NPI | 1487635686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL OS 7969) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA OS016616) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2015-09-24 |