| NPI | 1487770202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX N0583) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0046185) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-3591) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2016-12-19 |