| NPI | 1760633168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD69808) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 003225) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 83866) | |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2023-12-15 |