| NPI | 1518041615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 53689) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN MD36171) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD36171) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-11-02 |