| NPI | 1063709913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX Q1072) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q1072) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX Q1072) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2023-03-13 |