| NPI | 1841402609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX P9409) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 39028) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2009001616) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2014-07-22 |