| NPI | 1255702809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME144336) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 27418) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-13061) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 61012) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 306619) | |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2022-02-16 |