| NPI | 1225290497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME108598) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 18680) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01079706A) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301114220) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2023-09-21 |