| NPI | 1124072145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL MD.21198) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 21198) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2023-05-15 |