| NPI | 1710095369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 43851) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD479891) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301075005) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 46064) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2023-10-04 |