| NPI | 1649387234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD460041) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CT 22629) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2017-04-05 |