| NPI | 1588744320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CT 21971) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CT 021971) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2019-02-04 |