| NPI | 1164478111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL MFC1789) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX FTL 41266) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX FTL 42176) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX FTL 42588) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2022-07-21 |