| NPI | 1972777290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 30836) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-11799) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 26150) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 51336) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 58274) | |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2020-03-02 |