| NPI | 1114990587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60823049) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01052312A) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2023-03-07 |