| NPI | 1497732812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO R3A30) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036060396) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2020-11-05 |