| NPI | 1558312280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 21521) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2019-09-23 |