| NPI | 1982814570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: IN 01077756A) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: TX Q0629) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: LA PENDING) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-10-10 |