| NPI | 1174625610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WI 54351-20) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IN 01065870A) |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2025-04-25 |