| NPI | 1275595985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX E4566) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 12361745-1205) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2025-12-01 |