| NPI | 1760436893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 34595) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NC 34595) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2014-07-09 |