| NPI | 1003268889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 98555) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10056520) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX BP10056520) | |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2024-06-06 |