| NPI | 1477082022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 23531) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI LP04004) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2023-05-24 |