| NPI | 1366411514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL OS7448) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: FL OS7448) |
| 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: FL OS7448) | |
| 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: FL OS7448) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2024-04-09 |