| NPI | 1689834715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0069134) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101245666) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC 038036) | |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2010-03-25 |