| NPI | 1861526915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 50775) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD0000050775) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2019-02-01 |