NPI | 1205175338 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: TX U0860) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: TX U0860) |
2084N0400X Psychiatry & Neurology Neurology (Licence: CA A153399) | |
Enumeration Date | 2013-02-08 |
Last Update Date | 2024-03-26 |