| NPI | 1184043051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 6687) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL OS20836) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2026-02-25 |