| NPI | 1497712574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: WI 35171-20) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 35171-20) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2016-08-25 |