| NPI | 1982618476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 12102) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI 10766) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2014-02-14 |