| NPI | 1902873185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME85224) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 46873) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 22367) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-8569) | |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2020-02-10 |