| NPI | 1538359450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX F5926) |
| Additional Taxonomies | 2084N0600X (Licence: TX F5926) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2010-09-29 |