| NPI | 1831291590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2004-0093) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 49580) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2011-06-09 |