| NPI | 1588637136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 42528) |
| Additional Taxonomies | 2084N0600X (Licence: CO 42528) |
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: CO 42528) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2011-01-03 |