| NPI | 1497715098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00009804) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD15461) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2010-01-19 |