| NPI | 1073931309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: HI MD-22398) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036.145951) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61073392) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2022-07-25 |