| NPI | 1528257219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 30493) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 30521) |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2010-11-04 |