| NPI | 1891723284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: TN MD0000028134) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NH 21012) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME147120) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 042229) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2023-01-04 |