| NPI | 1801926100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: TN 51143) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: TN 51143) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2014-07-25 |