| NPI | 1316184674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PR 18243) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PR 18423) |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2025-10-01 |