| NPI | 1841298270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX J9197) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 23322) |
| Enumeration Date | 2005-07-10 |
| Last Update Date | 2014-02-10 |