| NPI | 1669652533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 9542) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-7489) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2019-06-04 |