| NPI | 1285016899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S1792) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA GETP.201466) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2020-09-15 |