| NPI | 1538101928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-6094) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ID m8819) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2023-07-12 |