| NPI | 1346404803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T4394) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 32638) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2025-02920) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2025-09-16 |