| NPI | 1811188006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101257379) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01095490A) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME153882) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 68653) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2024-12-19 |