| NPI | 1710919295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD35975) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 35975) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2017-02-06 |