| NPI | 1497733174 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 37701) | 
| Additional Taxonomies | 2084N0600X (Licence: AZ 37701) | 
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: AZ 37701) | |
| Enumeration Date | 2006-01-04 | 
| Last Update Date | 2012-09-18 |