| NPI | 1710944756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2002-00900) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 200200900) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2013-07-16 |