| NPI | 1134236102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX N2967) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX N2967) |
| 207T00000X Neurological Surgery (Licence: TX 41443) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2022-03-03 |