| NPI | 1235346099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 49679) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA R-7343) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2022-03-30 |