| NPI | 1831695774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2023025240) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GU DO-0127) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 0547857) | |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2024-01-18 |