| NPI | 1730236639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: MI 4301035133) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301035133) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2016-10-20 |