| NPI | 1740205889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 64970) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 64970) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2016-12-22 |