| NPI | 1841232709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VT 0420010335) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2002009605) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2014-07-10 |