| NPI | 1073826467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX Q1248) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301096326) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 40026) | |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2022-07-21 |