| NPI | 1760412852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DE C10008067) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101244794) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01070044A) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2016-08-03 |