| NPI | 1477787067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 50007) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY TP197) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL MD159726) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD213941) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2023014132) | |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2023-08-29 |