| NPI | 1255828893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ID M-17210) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 1255828893) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2023-09-06 |