| NPI | 1780674762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: AL 25521) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD38815) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2013-11-06 |