| NPI | 1629325394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: CT 56713) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: CT 56713) |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2018-03-17 |