| NPI | 1043578289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: TX S1615) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S1615) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2020-12-01 |