| NPI | 1225073794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: TX L3695) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX L3695) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2023-11-30 |