| NPI | 1679510283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD016929E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD016929E) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2015-02-05 |