| NPI | 1407018187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 45824) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01071068A) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2021-01-12 |