| NPI | 1225120017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-17332) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX L2036) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2026-09-09 |