| NPI | 1083096374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 90007) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10053390) |
| 2084N0600X (Licence: TX BP20057953) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX BP20057953) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S2659) | |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2022-02-14 |