| NPI | 1013275304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX Q8676) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10042772) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX BP20048261) | |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2026-05-17 |