| NPI | 1972727659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2010-01535) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 001891) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2012-05-03 |