| NPI | 1013982149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U1793) |
| Additional Taxonomies | 2084N0600X (Licence: TX U1793) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 45472) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2023-03-14 |