| NPI | 1730168964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01033304A) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME MD20023) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2014-07-16 |