| NPI | 1689941007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D74298) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD040483) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2013-05-21 |