| NPI | 1780974022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: PA MD450775) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD450775) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2016-06-10 |