| NPI | 1578719670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD038771) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125049883) |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2013-08-13 |