| NPI | 1619362068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 67497) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 83045) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 89199) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME144850) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2024-05-20 |