| NPI | 1093830572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY TP466) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: KY 51412) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 7072247-1205) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2023-04-17 |