| NPI | 1740306273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MO 2010034070) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: KS 04-06053) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: ID O-0465) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2012-01-20 |