| NPI | 1508160383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101041706) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: VA 0101041706) |
| 207U00000X Nuclear Medicine (Licence: DC MD19915) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD19915) | |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2011-01-07 |