| NPI | 1730144734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 038525) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD449541) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 39406) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 56805) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 25541) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-11754) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2020-02-11 |