| NPI | 1558396044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: HI MD-6595) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301405266) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2023-07-27 |