| NPI | 1609924174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301066290) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: HI MD-16258) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2025-04-24 |