| NPI | 1730666272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NM MD2023-1646) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: AZ 69363) |
| 208600000X Surgery (Licence: ND RL15189) | |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2025-04-22 |