| NPI | 1730382573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PR 16806) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 16806) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2014-01-06 |