| NPI | 1558406231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD431351) |
| Additional Taxonomies | 2084N0600X (Licence: PA MD431351) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2018-03-08 |