| NPI | 1316478373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: TX T2269) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T2269) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2024-01-29 |