| NPI | 1760461453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD36347) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN 36347) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2015-03-12 |