| NPI | 1063676690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 51679) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MS 20766) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: KY IP958) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: TN 56737) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2019-04-27 |