| NPI | 1528029618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MS 11567) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: TN MD0000014260) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2020-04-14 |