| NPI | 1669406146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 8566) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G39466) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VT 42-8834) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2012-04-09 |