| NPI | 1346260247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD205738) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD476184) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 187597-1205) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 21619) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT 99622) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 89191) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2023-01-03 |