| NPI | 1811955263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NH 7049) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: VT 042-0007986) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-09-07 |