| NPI | 1063426971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S4931) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 1664481205) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036141215) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 27943) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 44122) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2023-03-07 |