| NPI | 1346771078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T5072) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX T5072) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2024-09-30 |