| NPI | 1407297005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A149857) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: IN 01080969A) |
| 2084D0003X Psychiatry & Neurology Diagnostic Neuroimaging (Licence: CA A149857) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: IN 01080969A) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: SC LL36095) | |
| 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: CA A149857) | |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2020-10-15 |