| NPI | 1306822242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: TX P4585) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX 42653) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2024-04-17 |