| NPI | 1831396803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 059106) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: GA 059106) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2015-07-21 |