| NPI | 1730107038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: HI MD-17283) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 227243) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2021-05-26 |