| NPI | 1194702381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01045219A) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: IN 01045219A) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 32468) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2021-11-08 |