| NPI | 1720029317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PR 6775) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2011-03-01 |