| NPI | 1013478429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 73981) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2023010929) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-10-02 |