| NPI | 1801854641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN TN40612) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 40612) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2023-02-13 |