| NPI | 1215959697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: TX L7311) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX L7311) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2023-12-19 |