| NPI | 1851447569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 10900319-1205) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D66766) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2019-06-06 |