| NPI | 1780789214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CO 30904) |
| Additional Taxonomies | 208U00000X Clinical Pharmacology (Licence: CO 30904) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2007-07-08 |