| NPI | 1215467485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WI 81018-20) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: TN 63488) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2023-12-21 |