| 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 |