| NPI | 1740263227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 58797) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101269449) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 26332) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME98598) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 46958) | |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2024-05-10 |