| NPI | 1558740829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2021032811) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 73143) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AK 225516) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01093082A) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 36594) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25IA12987700) | |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2026-06-25 |