| NPI | 1942736251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: UT 10959196-1205) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 28473) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 111687) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2026-034559) | |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2026-08-03 |