| NPI | 1700814191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD0000037212) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 052458) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 9901555) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2023-02-28 |