| NPI | 1639699259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD-2021-0815) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM MD2021-0815) |
| Enumeration Date | 2017-06-24 |
| Last Update Date | 2026-04-14 |