| NPI | 1770078933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC LL61182) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC LL61182) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2021-05-18 |