| NPI | 1619921335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA MD.010208) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 010208) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2013-01-28 |