| NPI | 1215183512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: TX R0977) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: TX R0977) |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: MD D43756) | |
| 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: TX D43756) | |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2022-07-21 |