| NPI | 1659417772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A104453) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125-045776) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD27347) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2013-07-30 |