| NPI | 1033230800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD185769) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX M5808) |
| 2084N0600X (Licence: TX M5808) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2025-03-08 |