| NPI | 1558717611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5101025541) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 02006596A) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2025-03-03 |