| NPI | 1649387416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0074776) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60091919) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD040960) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2012-09-14 |