| NPI | 1013018431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: TN MD0000027717) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: VA 0101054282) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2025-08-22 |