| NPI | 1710326970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: OK 6128) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 125.063886) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2017-08-01 |