| NPI | 1689931149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA OS020342) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: OR DO177173) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2019-11-12 |