| NPI | 1619400520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 63022) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD219248) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61539013) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2024039432) | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2024-10-25 |