| NPI | 1285655290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 200301323) |
| Additional Taxonomies | 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: NC 200301323) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2024-07-15 |