| NPI | 1992708853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SD 4040) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA MD-26539) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2019-10-09 |