| NPI | 1710930003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D63715) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD D63715) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2013-02-20 |