| NPI | 1821538497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0045607) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 0044167-020) |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-03-02 |