| NPI | 1861541005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 43856) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SD 5674) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 215819-1) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2013-0786) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2013-11-21 |