| NPI | 1003934035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 124360) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL TPME235) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 54443) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 86476) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 60855) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01084726A) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2020-03485) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101268461) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G137693) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX Q8908) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2022-07-07 |