| NPI | 1316154370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX P3577) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 29805) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX P3577) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-03-23 |