| NPI | 1073649778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: TX P4714) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MA 239026) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MA L-224486) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-11-27 |