| NPI | 1639216773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D70791) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD P21548) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2013-02-21 |