| NPI | 1336672476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 72013) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61242889) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2024-11-13 |