| NPI | 1871541862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101040746) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101040746) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2011-03-24 |