| NPI | 1922101955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD17013) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00035579) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2007-07-08 |