| NPI | 1154762458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: TN 58050) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: LA 337618) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME165546) | |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2023-10-30 |