| NPI | 1497735740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 39214) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI SB049511) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01077914A) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2022-10-10 |