| NPI | 1558344622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: HI DOS-1100) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 31163) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2007-10-30 |