| NPI | 1962426692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: TX M5848) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: TX M5848) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2015-12-29 |