| NPI | 1689604019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD024475E) |
| Additional Taxonomies | 2084N0600X (Licence: PA MD204475E) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2013-08-07 |