| NPI | 1770519662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PR 12421) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: PR 12421) |
| 208600000X Surgery (Licence: PR 12421) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2017-01-28 |