| NPI | 1588695928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 74843) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 18697) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2025-07-14 |