| NPI | 1164059267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX W6884) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01094361A) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: ND 23899) | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2026-07-22 |